Test Lead - Pharmacy Benefit Manager (PBM)

Test Lead - Pharmacy Benefit Manager (PBM)

Shift: Candidates must be able to operate in Eastern Standard Time hours.

Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health.

The Test Lead - Pharmacy Benefit Manager (PBM) is responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals. Leads end-to-end testing activities for new client implementations ensuring readiness across systems, processes, and teams.

How you will make an impact:

• Partner with business, IT, and delivery stakeholders to ensure implementation readiness.

• Develop and manage test strategies, plans, schedules, and execution aligned to program milestones.

• Coordinate onshore and offshore teams, ensuring effective communication and delivery.

• Identifies potential issues, project charge, and scope.

• Identifies impacted parties, business partners, and resources required.

• Develops and designs processes and systems that support business needs.

• Designs methods for integrating function and process.

• Conducts cost/benefit analyses.

• Builds support for business change throughout the business unit.

Minimum Requirements:

Requires a BA/BS in a related field and minimum of 5 years process or project related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• 8+ years of experience in the US Healthcare domain (Commercial, Medicaid, Medicare), supporting pharmacy benefit management (PBM), including benefit administration, enrollment, and claims processing.

• 3+ years of leadership experience managing end-to-end testing for large implementations.

• Proven experience leading new client implementations or major onboarding initiatives.

• Experience with Jira, qTest, Blueprint, and Confluence; proficiency in MS Excel is strongly preferred.

• Strong ability to prepare and present executive-ready reports, dashboards, and status updates.

• Excellent communication, stakeholder management, facilitation, and analytical skills.

• Ability to thrive in dynamic environments and collaborate within matrix teams and familiarity with Agile methodologies.

• Experience with test automation tools, test data management, and quality metrics is a plus.

• Demonstrated success managing large, complex initiatives with significant operational or delivery budgets.

• Strong background in process redesign and business transformation initiatives preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $89,964 - $154,224

Locations: Maryland; Massachusetts; New York

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._

*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration ( .